# GREEN MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225918014
- **Authorized official:** DIEM LE RN (CORPORATE SECRETARY)
- **Authorized official phone:** (714) 655-8298

## Contact information

- **Practice address:** 995 W FOOTHILL BLVD, CLAREMONT, CA 91711-3304
- **Practice address phone:** (714) 655-8298
- **Practice address fax:** (808) 855-3055
- **Mailing address:** 995 W FOOTHILL BLVD, CLAREMONT, CA 91711-3304
- **Mailing address phone:** (714) 655-8298
- **Mailing address fax:** (808) 855-3055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2025
- **Last updated:** 09/03/2025